From: Howard C. Berkowitz (hcb@gettcomm.com)
Date: Fri Aug 22 2003 - 12:39:23 GMT-3
At 10:38 AM -0400 8/22/03, Charles Church wrote:
>Variation on a theme :)
>
>
>Hi I am new to the medical field I have a quick question for you doctors.
>What book should I read to be a surgeon? I read a book and now I am
>veterinarian. I want to continue my learning and become a smart medical
>guy. How can I get to the six figure plus salaries the fastest? I have
>very little medical experience except using drugs and a complete mastery of
>Milton-Bradley's 'Operation' board game but I can really scalpel around to
>get this stuff working. I think brain surgeon is the next logical step.
>Also I was reading about appendectomy and forceps, does
>anybody have any good explanations of how these thingies work?
Appendectomy? Assuming an open rather than laparoscopic procedure
1. Diagnose appendicitis. This is often the hard part.
2. Put patient to sleep or at least use a spinal anesthetic.
3. Using a #10 blade, incise the skin and subcutaneous fat, directing
the incision laterally and inferiorly through MacBurney's point
4. Changing to a clean scalpel, incise the four muscle planes and retract,
with appropriate hemostasis.
5. With a new scalpel, incise the omentum and peritoneum.
6. Locate the appendix and double-clamp the stump. If there is peritonitis,
call for help.
7. With a Metzenbaum scissors, cut between the clamps.
8. Rinse the area, suction, and suture the stump. Send appendix to
pathology so they can tell you what you removed. If you removed the
assistant surgeon's finger, you probably already know that.
9. Repair the incisions.
10. Wake up the patient.
11. Bill somebody.
Was that clear?
(begin standard rant about L3 switch), you have to realize the
boundary between forceps and clamps is sort of like the boundary
between routers and L3 switches. There is much more variability
within forceps and clamps than among Cisco products. Offhand, clamps
I've used include Kelly, Mayo, mosquito, Crile and Ochsner styles,
with straight and bent tips, traumatic and atraumatic tip finishes,
and an assortment of lengths.
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